The present paper is informed by a general statement: that
almost all work on nutrition and public health has overestimated
the significance of nutrients and of foods as such,
and has underestimated or even overlooked the significance
of processing. To express this rather more strongly: ‘The
issue is not foods, nor nutrients, so much as processing’(1).
Authoritative reports, official and other dietary guidelines,
and other documents concerned with food and
health, accept or assume that processed foods and drinks
are implicated in the current pandemics of obesity and
chronic diseases(2,3). The manufacture and supply of such
products have expanded globally(4). Yet time trends in
consumption are largely unknown, especially in lowerincome
countries. Instead, studies examining dietary